How is excess tissue removed from the tip of the nose?
Answer: Bulbous tip By refining the tripod of cartilages that contribute to the bulbous shape. This is done by resecting the tip cartilages, suturing them together and adding cartilages on top that are harvested from your septum or ear.
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CONTACT NOW Answer: Bulbous tip By refining the tripod of cartilages that contribute to the bulbous shape. This is done by resecting the tip cartilages, suturing them together and adding cartilages on top that are harvested from your septum or ear.
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CONTACT NOW Answer: Tip refinement Hello and thank you for your question. Tip refinement can be accomplished by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person. Best wishes and good luck. Richard G. Reish, M.D. Harvard-trained plastic surgeon
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CONTACT NOW Answer: Tip refinement Hello and thank you for your question. Tip refinement can be accomplished by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person. Best wishes and good luck. Richard G. Reish, M.D. Harvard-trained plastic surgeon
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October 13, 2021
Answer: Strategies for a bulbous tip As a specialist in rhinoplasty surgery, I employ many different techniques for trimming, reshaping and suturing together the distal tip cartilage to form a more defined tip for both males and females. This can be performed with the open or closed technique. The reason that I have developed such a pantheon of different approaches is because no two noses are alike. (I’ve operated on identical twins, and even they had slightly different nasal structures.) Many different aspects of the nose must be factored in, such as the relation of the bony element to the tip (the line of the nose should be confluent), the thickness of the skin, the desired result. I have seen subpar results from other offices, and especially from other countries, in regard to mishandling of the tip. What should never be created is a nose that is too disproportionately small for someone’s face, or a tip that plunges upon smiling. I’ve seen blunted tips, twisted tips, overly rotated tips, visible scaring and on and on. I can not stress how important it is to study the before-and-after photos of every surgeon you consider, and ask yourself if you share the same aesthetic. Also make sure that the surgeon is a board certified plastic surgeon with decades of experience in rhinoplasty surgery
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CONTACT NOW October 13, 2021
Answer: Strategies for a bulbous tip As a specialist in rhinoplasty surgery, I employ many different techniques for trimming, reshaping and suturing together the distal tip cartilage to form a more defined tip for both males and females. This can be performed with the open or closed technique. The reason that I have developed such a pantheon of different approaches is because no two noses are alike. (I’ve operated on identical twins, and even they had slightly different nasal structures.) Many different aspects of the nose must be factored in, such as the relation of the bony element to the tip (the line of the nose should be confluent), the thickness of the skin, the desired result. I have seen subpar results from other offices, and especially from other countries, in regard to mishandling of the tip. What should never be created is a nose that is too disproportionately small for someone’s face, or a tip that plunges upon smiling. I’ve seen blunted tips, twisted tips, overly rotated tips, visible scaring and on and on. I can not stress how important it is to study the before-and-after photos of every surgeon you consider, and ask yourself if you share the same aesthetic. Also make sure that the surgeon is a board certified plastic surgeon with decades of experience in rhinoplasty surgery
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October 27, 2020
Answer: Refine the cartilages underneath A bulbous tip typically requires an open rhinoplasty to assess the cartilages underneath and refine them as needed. This is done by a combination of removal of excess or large cartilages, suturing techniques to mold the cartilage into certain shapes, etc. I also assess the quality of the skin and soft tissue envelope. Select patients have very thick fatty layer under the skin which makes the nose appear more bulbous. In these patients I carefully thin out the envelope, making sure to leave behind enough blood supply to avoid wound healing problems. Lastly, if all of those maneuvers do not work, I sometimes use tip grafts under the skin to further define and construct the nasal tip that is desired and balances the nose appropriately. This is one of the most fun parts about rhinoplasty! -David Mattos, Harvard-trained plastic surgeon
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CONTACT NOW October 27, 2020
Answer: Refine the cartilages underneath A bulbous tip typically requires an open rhinoplasty to assess the cartilages underneath and refine them as needed. This is done by a combination of removal of excess or large cartilages, suturing techniques to mold the cartilage into certain shapes, etc. I also assess the quality of the skin and soft tissue envelope. Select patients have very thick fatty layer under the skin which makes the nose appear more bulbous. In these patients I carefully thin out the envelope, making sure to leave behind enough blood supply to avoid wound healing problems. Lastly, if all of those maneuvers do not work, I sometimes use tip grafts under the skin to further define and construct the nasal tip that is desired and balances the nose appropriately. This is one of the most fun parts about rhinoplasty! -David Mattos, Harvard-trained plastic surgeon
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June 6, 2018
Answer: Fixing a bulbous nose Thank you for this great question which many patients contemplating or undergoing Rhinoplasty for this specific concern are sure to ask. There are multiple factors that contribute towards tip bulbosity. The size, shape and orientation of the tip cartilages (lower lateral cartilages) are a major determinant of how wide or bulbous a tip is. The quality and thickness of the skin and underlying soft tissues (soft tissue envelope) can also influence the bulbosity of a tip. Through careful examination, an experienced Rhinoplasty surgeon will be able to determine the factors contributing to the bulbosity of your nose and what approaches to take to improve and refine tip appearance. Occasionally, the soft tissue envelope, if too thick, can preclude significant alterations in how wide/narrow a tip is. Although tip rhinoplasty can be performed through a closed approach (which entails "delivering" the tip cartilages out from either side of the nose), I prefer the open approach for any exacting changes to the tip so I can ensure precise modifications and tip symmetry as I am performing the procedure and on final examination before closing. I hope this was helpful!
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CONTACT NOW June 6, 2018
Answer: Fixing a bulbous nose Thank you for this great question which many patients contemplating or undergoing Rhinoplasty for this specific concern are sure to ask. There are multiple factors that contribute towards tip bulbosity. The size, shape and orientation of the tip cartilages (lower lateral cartilages) are a major determinant of how wide or bulbous a tip is. The quality and thickness of the skin and underlying soft tissues (soft tissue envelope) can also influence the bulbosity of a tip. Through careful examination, an experienced Rhinoplasty surgeon will be able to determine the factors contributing to the bulbosity of your nose and what approaches to take to improve and refine tip appearance. Occasionally, the soft tissue envelope, if too thick, can preclude significant alterations in how wide/narrow a tip is. Although tip rhinoplasty can be performed through a closed approach (which entails "delivering" the tip cartilages out from either side of the nose), I prefer the open approach for any exacting changes to the tip so I can ensure precise modifications and tip symmetry as I am performing the procedure and on final examination before closing. I hope this was helpful!
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June 26, 2017
Answer: Closed Rhinoplasty Hello,In a closed rhinoplasty approach, many different options are available depending on the nose. We can perform subtle refinements of the nasal tip through a scarless approach using endonasal techniques to size, shape and positioning of the nasal tip cartilages. Depending on your need we have an answer to address it with our closed scarless technique. Sometimes it's as simple as carving and sculpting your current cartilage. Sometimes we need to reposition the tip cartilages with delivery and suture techniques. Sometimes we need to use small grafts to enhance the projection or rotation of the tip. Consult with a board certified facial plastic surgeon for a consultation to see exactly what procedure you want and need. All the best, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210
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CONTACT NOW June 26, 2017
Answer: Closed Rhinoplasty Hello,In a closed rhinoplasty approach, many different options are available depending on the nose. We can perform subtle refinements of the nasal tip through a scarless approach using endonasal techniques to size, shape and positioning of the nasal tip cartilages. Depending on your need we have an answer to address it with our closed scarless technique. Sometimes it's as simple as carving and sculpting your current cartilage. Sometimes we need to reposition the tip cartilages with delivery and suture techniques. Sometimes we need to use small grafts to enhance the projection or rotation of the tip. Consult with a board certified facial plastic surgeon for a consultation to see exactly what procedure you want and need. All the best, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210
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